1. Field of the Invention
This invention concerns a device and method to mechanically perform myofascial release and deep tissue massage on tendons and soft tissues in the limbs to achieve relief from conditions such as carpal tunnel syndrome, wrist tenosynovitis and tendonitis, cubital tunnel syndrome, neck tendonitis, plantar fasciitis, Achilles tendonitis, and other soft tissue dysfunctions of the hand, wrist, forearm, leg, ankle, foot, and neck.
2. Background of the Invention
Carpal tunnel syndrome, wrist tenosynovitis and tendonitis, cubital tunnel syndrome, plantar fasciitis, and Achilles tendonitis each describe a condition where tendons and adjacent tissues are inflamed. In tenosynovitis and tendonitis the inflammation is confined to the tendon's sheath or the tendon proper, respectively. There is usually little or no paratendinous involvement. Pain and tenderness over the involved tendon usually results. In carpal tunnel syndrome the inflamed tendons impinge on the median nerve inside the carpal tunnel in the wrist. Similarly, in cubital tunnel syndrome the ulnar nerve is entrapped inside the cubital tunnel of the elbow. Since this is a small confined space, the nerve is effectively pinched or squeezed. The area becomes inflamed and micro-adhesions form between and around the tendons. The result is pain, numbness, tingling, burning and weakness in the hand. In either of these conditions, patients seek treatment, such as, to reduce inflammation, because the pain can be debilitating.
Treating soft tissue dysfunctions such as carpal tunnel syndrome, wrist tenosynovitis and tendonitis, cubital tunnel syndrome, neck tendonitis, plantar fasciitis, and Achilles tendonitis goes beyond alleviating the pain and suffering experienced by patients. Carpal tunnel syndrome is the reason that 3 in 10,000 workers lose job time. The lifetime cost of carpal tunnel syndrome is approximately $30,000 per employee. Cubital tunnel syndrome is less pervasive, yet just as debilitating. While the numbers are not exact, similar burdens on the economy result from tenosynovitis and tendonitis, which are often called repetitive strain injuries or RSIs, plantar fasciitis, and Achilles tendonitis.
Nonsurgical treatment techniques for any of these conditions usually are successful when properly applied. However, such treatment options are quite limited.
Aside from medicines, the most common nonsurgical treatment by far is wrist immobilization and rest. Using an orthopaedic device such as a hand splint or brace is often effective in achieving relief. However, oftentimes such relief is temporary, especially, for instance, if the hand is used too early after a rest period.
When rest is used in combination with certain hand and wrist exercises, the results are better. Such exercises help alleviate inflammation and pain since they promote drainage of interstitial fluid from the affected tissues and breakup of micro-adhesions, which subsequently relieves pressure on sensory nerves.
Oral medications such as nonsteroidal anti-inflammatory drugs or NSAIDs also help to reduce pain, inflammation, and the associated pain. They are commonly used to alleviate the symptoms of carpal tunnel syndrome, wrist tenosynovitis and tendonitis, cubital tunnel syndrome, neck tendonitis, plantar fasciitis, and Achilles tendonitis.
Corticosteroid injections into the inflamed area also help to reduce inflammation, swelling and pain, especially in treating carpal tunnel syndrome. Since corticosteroids are not safe for long term use, injections are limited to only a few during the patient's life.
Surgery aims to alleviate more severe symptoms of carpal tunnel syndrome, wrist tenosynovitis and tendonitis, cubital tunnel syndrome, plantar fasciitis, and Achilles tendonitis. Surgery for tendonitis and tenosynovitis can relieve adhesions and result in pain relief. The outcomes of such surgery are usually fair to good. For alleviating carpal tunnel syndrome, surgery aims to cut the transverse carpal ligament so that the carpal tunnel snaps open. This relieves pressure on the median nerve caused by the inflamed tendons. Surgery for cubital tunnel syndrome usually involves either transposing the ulnar nerve or removing impinging bone.
Carpal tunnel syndrome and cubital tunnel syndrome surgery results are less than perfect. Many times the surgery simply fails to achieve relief. Other times it results in return of symptoms within one to two years. More frequently there are long lasting deficits such as numbness or weakness.
A common technique used by some healthcare practitioners to relieve symptoms of carpal tunnel syndrome, wrist tenosynovitis and tendonitis, cubital tunnel syndrome, neck tendonitis, plantar fasciitis, and Achilles tendonitis is massage. The underlying cause of all of these conditions is inflammation and the resultant micro-adhesions that develop amongst the tissues. Expert massage is an effective way to reduce inflammation and break such adhesions.
Massage techniques aim to move or manipulate tissues in order to achieve a particular result. When properly performed, massage can break adhesions that form when tissues have been damaged. In addition to adhesion breakup, massage makes tissues suppler and easier to glide against adjacent tissues. Finally, massage aids drainage of interstitial fluid through the lymphatic system. This enables waste material to be flushed away from the inflamed area, further enabling healing and reducing swelling.
Combined with massage, joint immobilization is also therapeutic. Maintaining the joint in a neutral or unstressed position allows natural healing processes to transpire unimpeded. This rest period enables the recovery of normal physiology, but if the joint becomes mobile again before healing occurs, more injury can result.
A skilled practitioner such as a massage or physical therapist understands how to move tissues in a three dimensional pattern to maximize the manipulative effect.
On the forearm, as in treating carpal tunnel syndrome, for example, the three dimensional motion produced by a therapist moves the forearm tendons in a forward, backward, side-to-side, and up-and-down direction. Since the tissues are three dimensional structures, only such manipulation can insure thorough movement under the skin to ultimately achieve good results.
One skilled in deep tissue massage techniques may perform this therapy on his or her other arm. It is difficult to achieve good deep tissue massage and myofascial release on your opposite arm since two hands are generally optimal to achieve this. Even when a spouse is instructed to massage the patient, the regimen usually wanes after a few days. This is because most people lack the stamina or skill for a proper deep tissue technique to achieve myofascial release, even when compliance means pain relief for a loved one.
It is desirable to provide a device and method to alleviate carpal tunnel syndrome and dysfunctions of other soft tissues.